Lesser Known Facts

"Hi, I'm Andrea.  I'm wondering if your clinic would perform an embryo transfer with embryos donated from another clinic?" 

Who'd have thought that finding a fertility clinic would be so hard? 

In Virginia, there were three local fertility clinics that shared one cryogenics lab - all embryo transfers were performed at the same facility.  Lucky for us, they did accept embryos from another clinic.

I'm running into a slight problem here.

There are no clinics in our city.  The closest is through a major central Texas hospital chain - two clinic locations each 45 minutes away in opposite directions from here.  However, they do not accept embryos from another clinic.

I move on to the closest big city and continue with the phone calls.  We're now looking at a 1 to 1.5 hour drive to these clinics.  I've been told we're not far enough away to merit local monitoring (ultrasounds), so we'll have to make appx three trips in a single cycle.  If they answer yes to my original question, that is.

I continue down my list of clinics.

"No."

"Yes, probably."

Left message.

"I have no idea."

I'm going to wait a day and see what responses I get back.  I have three avenues left if all the "local" clinics don't pan out.  Option A - radiate my search out further to the two major cities that are about 3 hours away and see if I will considered a "long distance patient" so we only have to travel a minimum number of times in the cycle.  Option B - Look at the cities where my parents and my in-laws live.  Be considered a "long distance patient" and tie the embryo transfers in with a family visit.  Option C - Travel to the clinic where the embryos are currently stored.

While Option C supposedly knocks off $1000 to $2000 from our adoption costs, it will incur unknown travel costs (depends on where the embryos are located in the States). 

On one hand, all this research is a little premature since we won't even enter into the matching stage with our embryo adoption agency until some time after Christmas.  On the other hand, my type A brain needs the rough details so I can build some plans.

For the moment, I'll have to be patient, and just wait for my calls to be returned.

Oh the craziness that is my brain

I can't say that I worked constantly on our home study.  It was more like a few days on and a few days off.  With the exception of a few details coming from other sources, I'm done with the bulk of the paperwork.  Woohoo! 

Between working on our paperwork and hearing a constant stream of birth/pregnancy announcements, babies have been on my mind.  A lot.

I've always had vivid dreams.  It's no surprise that babies and/or embryo adoption has worked its way into my dreams, albeit in a bizarre fashion.

Last night's dream started with me and Bryan completing some sort of obstacle course.  The final leg, I completed by myself - dangling from wooden handholds while suspended over water.  We finished triumphantly and then moved on to the fertility clinic.  There I was greeted by some Southern belles bustling about and counseling me on good dental care.  They cleaned my teeth for me, chattering away about how sparkling teeth are of utmost importance for an embryo transfer.

The chatter never ceased as I was ushered into the transfer room.  Apparently a match had been made for me - I knew absolutely nothing about the embryos.  I kept requesting more information on the embryos and the genetic family, but I only kept hearing the same generic info from the smiley blank faces over and over.  Three embryos, two blasts and one the next stage.  "There's a next stage?"  I'd ask.  "Oh, honey, of course there is!"  And that'd be all the information I got.

Transfer occurred.  Next thing I knew, I was repacking my bags hurridly, trying to leave the resort before I was charged for an extra day.  A nurse strolled in, "Sorry, dear, the embryos didn't survive the transfer.  You're not pregnant."  And I was left gaping, holding mismatched socks.

"How can that be? You just performed the transfer!"

The nurse strolled back out as I was protesting that it was simply too soon to know the results of a transfer.

I resumed my frantic packing, thinking this was the weirdest resort I'd ever stayed in.  And thinking I didn't like how this transfer went down.  At least my teeth were clean.

Playground observations

We took the kids to the playground yesterday.  It was overcast and in the low 70's, unusual for September in central Texas.  No surprise, then, that there were a gazillion other kids there too.

Parents were conspicuously absent.  There were a few doting parents here and there, usually associated in some way with toddlers who were just learning to climb.  Many parents were sitting in their cars, texting, talking on their phones, or listening to ipods. 

One dad immediately stood out to me.  When he wasn't cuddling with his son on the bench, he was beaming with joy, watching his young boy explore the playground equipment.  The dad was attentive, calm, and happy to share the nice afternoon with his son. 

I didn't notice it immediately.  But when I did, I couldn't stop thinking about it.  That little boy was the first black child I had ever seen with Down Syndrome.  And he was beautiful. 

I wanted to tell the dad many things.  Thank you, thank you for letting him live.  Thank you for being a wonderful testimony of what it means to parent a special-needs child.  Thank you for letting me witness your joy.

But I didn't.  I thought that might be too strange coming from an absolute stranger.  Instead, we smiled at each other as our kids played peek-a-boo through the playground equipment.  We chuckled together as our boys beat out a rhythm on a table top.

****


I'm still thinking today - Lord, how do you want us to grow our family?  What comes next after this next round of embryo adoption?  Are you calling us to special needs adoption?  I sometimes have to avoid reading descriptions of waiting children because I want to rescue them all; I get very emotionally attached and feel pain at the grievances in their lives. 

God, I'm not quite sure where You're sending us long term (or really even short term!), please lead us to the little ones who need us the most. 

Back in the Game

Now that our house in Virginia is finally rented, we're jumping back into the adoption arena again!

While there are many different ways to pursue embryo adoption or embryo donation, we feel very strongly that a traditional adoption process (or as close as one can get) is the most dignified manner of adopting embryos.

This means we'll first procure a home study through a local agency.  Last time we worked with Bethany Christian Services for this step.  They were an expensive choice, but worth it, we thought, because they were located nationwide. We thought future home studies could be streamlined by always working with the same agency.  And then God laughed, because the Army sent us to a state in which Bethany has no presence. 

Instead of Bethany, we're now going to be working with Generations Adoptions (out of Waco) for our home study.  Lucky for us, this agency's home study is way cheaper than last time.  Woo hoo!

Once our home study is completed, we'll move on to the embryo adoption part with Nightlight's Snowflake Program. 

Here's the projected timeline, but since so much of the paperwork has to be compiled from third parties, it's anyone's guess as to the actual timeline.  We also try to not move on to the next step until the prior step is paid for.  Since we're a one income family this time around, things may move a little more slowly due to finances.

October - submit initial paperwork for the home study.
Late fall - complete home study; submit Nightlight's Snowflake application
Late winter - early Spring 2013 - complete Snowflake paperwork; be matched with embryos
Late Spring 2013 - embryo transfer prep and embryo transfer

And I know, now that I've published the projected timeline, that things will not go according to plan.  That's life.  If nothing else, I'm making this public so you can nag me about completing paperwork.  ;-)

Home studies vary a bit from agency to agency.  Here's our checklist for Generations' contracted home study, just to give you a feel for the process.

STEP 1

• Submission of the application for contracted home study
• Submission of supporting documents:
• photo of couple
• photos of home exterior (including front and back yards)
• criminal background check
• copies of drivers licenses
• lists of addresses (include county) for past 10 years
• fingerprinting ($44.20 per adult in the home)
• provide a floor plan of the home (including dimensions of rooms and purposes)
• provide directions to home
• provide autobiography for each parent
• statement of income (last year's W-2 form)
• copy of savings and checking account statements for 2 months
• proof of health insurance coverage
• proof of life insurance coverage
• five references (four from non-relatives, one from a relative) - agency will contact from addresses in application
• proof of employment (pay stubs for each parent)
• good employment record (resume for each parent)
• copy of marriage license
• birth certificates for entire fmaily
• medical evaluation forms for entire family
• sign acknowledgment of behavior policy

STEP 2

• Home study visit completed (with all family members present)
• Environmental inspection
• fire inspection
• $1500.00 home study fee

There are a few key differences that we've already noted between Bethany and Generations.  Price.  The number of interviews (Bethany required four, I think, and Generations just one).  Number of references (Bethany required fewer than Generations).  Depth of list of addresses (means we've got to include a UD address!).

Not only do I have my work cut out for me, if I'm to make my personal goal of submitting Step 1 items by October 1, but I'll also need to start nagging Bryan.  Some couples may operate differently, but I make him write his own autobiography.  And let me tell you, writing an autobiography is not one of his favorite ways to pass time.

Me and the Media

Our last few weeks in Virginia, I decided that I didn't have enough on our plate with packing, renting out our house, researching places to live in Texas, and the normal day to day toddler antics. Given my ample free time (hah!), I agreed to be interviewed by a reporter out of Northern Virginia for a piece on embryo adoption.

I was beyond nervous as the interview approached. Would I be represented fairly? Would the Church's point of view be represented appropriately (both by me and then through the editing stage)? How would the kids behave during the filming?

I'll be honest, filming was tough. I was wired for sound and had to attempt to sit in one spot on my couch for an hour while the kids roamed about. And by roamed about, I mean over, under, and around me. Overall, though, the newspeople were able to piece together a decent clip.

There's also a short article that accompanied the news footage: "Controversial Embryo Adoptions on the Rise".

My largest complaint is that the reporter/editor spelled our son's name wrong - he's Mac and not Max. And if that's the only complaint I have, I think everything turned out okay.

Interesting Possibilities

Being a military couple puts a damper on adoption.  In addition to working around finances, we have to struggle with adoption timing due to moves and deployments.  We couldn't start adoption two until the kids were at least nine months old.  Bryan was deployed then.  He came home in September when the kids were 14 months old.  The Army then told us we'd be moving in May.  While I appreciate the long notification, that just means that many more months to wait until we start the next adoption.  To make things even more complicated, embryo adoption is neither eligible for the federal adoption tax credit nor the military adoption credit.  So we will pay for each and every adoption we choose to do out of pocket.

When you add up all the expenses, it cost somewhere around $15,000 in order to bring home our twins (home study, snowflake adoption fees, transfer #1 (miscarriage), transfer #2, medications).  Now that I don't work for money (I'm never going to say being a stay at home mom isn't work!), it will be very difficult to finance subsequent adoptions. 

We will have a couple of financial breaks this time around though.  First, our next home study will be almost $2000 cheaper - different adoption agency.  Second, repeat patrons of Nightlight's Snowflake Adoption program receive a $500 discount.  Third, we learned last time that a frozen blastocyst transfer (embryos that are five or six days old) is a lot cheaper than those in the day one to three stage.  I believe this is because the clinic doesn't have to do as much to prep the embryos for transfer, but that's only my own semi-educated guess.  While we won't turn down embryos because of their development age, it is something to be mindful of...

Nightlight has had two webpages up that I've been checking over the months.  One is a page of waiting multi-ethnic embryos and another is a page of "special need" embryos.  (Sorry, I can't link to the multi-ethnic page currently - Nightlight is in the process of updating their website and they haven't added family profiles back to this page yet.)  All of these embryos are highlighted because they will be more difficult to place either because of race, number of embryos, or medical history.

One particular family caught my eye, "Sonya and Gary's" embryos.  They're listed on the page linked above.  The medical issue isn't a concern for us and eight blastocysts presents a very interesting hypothetical scenario.  I've already contacted the Snowflake program and gotten a little bit more information which has only increased my interest.

Blastocysts have much higher survival rates than less developed embryos.  You can look up statistics online, but our own personal story is pretty much on par with current success rates.  Our first transfer consisted of four embryos, all day one or two.  Two survived the thaw (50% survived thaw), one implanted (25% implanted), and we miscarried around eleven weeks.  Our second transfer consisted of three day six blasts.  All three survived the thaw (100%), and two implanted (66.6% implantation rate).  And our twins were born very healthy and full term.

"Sonya and Gary", pseudonyms, have eight day five and six blasts, frozen in four straws.  While it's not definite, one can assume that the embryos are frozen two in each straw.  When one adopts embryos through Nightlight's Snowflake program, the adopting family receives all of the embryos.  So one could thaw one straw at a time at the pace desired by the adopting family.

Way back when Bryan and I got married, we hoped for a large family.  I joked about having six to eight kids; he wanted a more conservative four or five.  When reality hit in the form of infertility, compounded by limited finances and military life, we realized our plans for a large family were almost definitely an impossible dream.  Adopting a larger set of embryos could prove to be a way to our original family goals.

At this point, Sonya and Gary's embryos present a hypothetical scenario, one that's provided some interesting converstations between me and Bryan over these last few days.  (Sadly, we're still months away from actually being able to adopt embryo at this point.  Darn move.) 

If we adopt a larger set of embryos:

• any remaining embryos after a transfer, whether or not the transfer itself results in a live birth, still remain ours
• we would not have to pursue a home study for each subsequent adoption
• we would have the freedom to pursue transfers on our own time, rather than factoring in an addtional six month plus period for a home study and matching
• we would only have to pay for a transfer (anywhere from $1500 - $3500) rather than the whole home study/adoption/transfer work-up

If we were to actually adopt Sonya and Gary's embryos (not outside the realm of possibility), we'd have to be mindful of all the probable outcomes.  A 100% success rate would mean all of the embryos would survive as we thawed and transferred them over the next 10 - 12 years bringing our family up to a total of ten children.  Wow!  For an infertile gal, that's mind-boggling.  ;-)  This would mean I would have born five sets of twins; wild, huh?!

If we used our previous statistics as an example, we could expect approximately two thirds of the embryos to survive.  Our family would grow by an additional five or six children.

Even if one looks at the national statistics for the survival rates of a single frozen blast (40.7% pregnancy rate), that would mean our family would potentially grow by at least three more children.

As I said earlier, it's simply mind-boggling.  I'll admit, Bryan's a little overwhelmed by the concept of eight blasts.  One of the caveats of embryo adoption is the statistics game.  While four more children is a fairly safe, easily comprehendable number, one must be aware that God alone knows how many children will result.  And, though not statistically likely, it could be eight.  Or none.

So now we're discerning.  In this hypothetical scenario, how many embryos would we be willing to adopt?  We hadn't fully considered the perks (though the word "perks" almost seems too crass to be used here) of adopting a large embryo set.  Essentially a larger embryo set would allow us to grow our family on our own time, a thing unheard of for a couple limited by infertility.

My brain is simply swimming.  On top of thinking about renting our house, packing, and driving halfway across the country with toddlers, I'm now adding hypothetical adoption questions to the mix.

Jesus, I trust in you.  I must say this dozens of times each night, when I'm trying to force my overactive brain into submission and let sleep take over.  Jesus, I trust in you.

Pondering the other side

When you adopt through Nightlight's Snowflake Embryo Adoption program, the adoptive family receives three generations of medical history on the genetic family.  While I don't know the exact age of Cora and Mac's genetic siblings, my hypothesis is they (the triplets) were about fifteen months old.  I'm using Cora and Mac's height and weight records as comparisons.

Cora and Mac will be eighteen months old tomorrow.  Everyday I marvel at their progress, their physical growth, their developing language skills, their ever expanding interest in the world around them...  I cannot imagine life without them.

I'm sure every adoptive parent wonders what prompted the placing parents' decision.  Was it financial?  Emotional?  Mental?  Did physical limitations push the placing parents in one direction?

I used to think it would be harder for birth parents to give up their infant through regular infant adoption than genetic parents through embryo adoption.  I guess I always thought that nine months would build such a deep connection that severing it, even for the most noble of reason, would hurt bitterly.  And I'm sure it does.

However, now I wonder if the genetic parents might suffer just as deeply too.  Every day they stare into the face of their children, little beings that bring them so much joy, and know that there are more out there.  Children who look just like their own kids, yet call another woman "Momma" and another man "Daddy".  Do their children even know they have more siblings?

In mid-November we heard from the genetic parents for the first time since the twins were born, a polite request for an update.  We sent a brief update and some pictures.  We haven't heard back.  I have to wonder, do the pictures hurt?  Do they remind the genetic parents of what might have been?  Cora is the splitting image of one of her genetic sisters.  Mac and his genetic brother have the same chin, the same "Winston Churchill" protruding bottom lip.  Do the genetic parents see this too?

I can't pretend to understand the "other side".  I've never been there.  I have no frame of reference.  All I know is the two little beings whom I love so very much would not be here if someone else had not made that infinitely hard decision.  And I pray that God may soothe their hurts and calm their fears.